KENNETH EDWARD SAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111948

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

EDWARD

Last Name

SAUM

Suffix

Business Name

KENNETH EDWARD SAUM MD

Original Issue Date

07/26/2004

Effective Date

07/15/2011

Expiration Date

07/31/2014

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

11/17/2014